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Association of Asthma Severity and Bronchial Hyperresponsiveness With a Polymorphism: Asthmatic airways

The first possible shortcoming of this study was that the methacholine challenge was performed in only 45 of 88 patients, which would have resulted in a selection bias. The most important reason for not performing the methacholine challenge concerned the patients’ respiratory state. It was difficult to perform the test when FEV1/FVC was reduced or when symptoms such as cough, dyspnea, and wheezing were present. Another reason was patient refusal. A much larger number of subjects would have to be studied in the future. Second, the male/ female ratio differed significantly between the control group and the asthmatic group. Therefore, we analyzed the association between sex and the polymorphisms (exon 1 +49 A/G, promoter —318 C/T) in all 174 subjects (54 male subjects and 120 female subjects) in the asthmatic and control groups. For the CTLA-4 promoter (—318 C/T) polymorphism, the distribution of genotypic frequencies did not differ by sex in all subjects (x2, p = 0.738), the asthmatic group (x2, p = 0.943), or the control group (X2, p = 0.516). For the CTLA-4 exon 1 ( + 49 A/G) polymorphism, the distribution of genotypic frequencies did not differ by sex in all subjects (x2, p = 0.818), the asthmatic group (x2, p = 0.191), or the control group (x2, p = 0.914). Therefore, we think it is possible that the difference in male/female ratios did not influence the conclusion of the study, In conclusion, the CTLA-4 promoter (—318 C/T) T allele may serve as a clinically useful marker of severe asthma, and the CTLA-4 exon 1 (+49 A/G) polymorphism may have a disease-modifying effect in asthmatic airways. buy antibiotics